Publications by authors named "Jean Christophe Farges"

Regenerative endodontic procedures (REP) aim at reestablishing tooth vitality by replacing the irreversibly damaged dental pulp removed by the dental practitioner with a new functional one. The current treatment of advanced caries relies on the replacement of the inflamed or necrosed dental pulp with an inert filling material. This leads to a functional but non-vital tooth, which lacks the ability to sense dental tissue damage, and to protect from further bacterial attack.

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Article Synopsis
  • The study focuses on developing a standardized model for examining the early apical release kinetics of molecules from endodontic hydrogels used in regenerative endodontic procedures (REPs), which are designed to enhance tooth regeneration.
  • The researchers created Endodontic Release Inserts (ERIs) using 3D printing to simulate immature incisors and tested the release of different fluorescent molecules from various hydrogels in different media.
  • Results showed that increasing the diameter of the apical release sites and changing the medium to human serum significantly affected the release rates of the tested molecules, indicating the complexities involved in optimizing REPs for clinical use.
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Regenerative endodontic procedures (REPs) aim at recreating dental pulp tissue using biomaterials such as hydrogels. Their bioactivity is mostly related to the nature of biomolecules or chemical compounds that compose the endodontic hydrogel. However, many other parameters, such as hydrogel concentration, bioactive molecules solubility, and apex size, were reported to influence the reciprocal host-biomaterial relationship and hydrogel behavior.

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Background: The clinical results following regenerative endodontic procedures (REPs) vary according to numerous parameters, including the presence of bacteria. This limitation reduces the indications for REPs and calls for the development of next generation antibacterial strategies (NGAS) providing alternatives to current antibacterial strategies (CAS) such as double or triple antibiotic paste (DAP/TAP) and (Ca(OH)2).

Objectives: The present scoping review aims to describe the current trends regarding the use of such strategies and highlight future perspectives.

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The biomechanics of transplanted teeth remain poorly understood due to a lack of models. In this context, finite element (FE) analysis has been used to evaluate the influence of occlusal morphology and root form on the biomechanical behavior of the transplanted tooth, but the construction of a FE model is extremely time-consuming. Model order reduction (MOR) techniques have been used in the medical field to reduce computing time, and the present study aimed to develop a reduced model of a transplanted tooth using the higher-order proper generalized decomposition method.

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Background: The present study aimed to classify the relative contributions of four biomechanical factors-the root-end filling , the apical , the root , and the -on the root stresses of the resected premolar.

Methods: A design of experiments approach based on a defined subset of factor combinations was conducted to calculate the influence of each factor and their interactions. Sixteen finite element models were created and analyzed using the von Mises stress criterion.

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Pulpitis is the inflammatory response of the dental pulp to a tooth insult, whether it is microbial, chemical, or physical in origin. It is traditionally referred to as reversible or irreversible, a classification for therapeutic purposes that determines the capability of the pulp to heal. Recently, new knowledge about dental pulp physiopathology led to orientate therapeutics towards more frequent preservation of pulp vitality.

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Finite element (FE) models are widely used to investigate the biomechanics of reconstructed premolars. However, parameter identification is a complex step because experimental validation cannot always be conducted. The aim of this study was to collect the experimentally validated FE models of premolars, extract their parameters, and discuss trends.

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During dental prosthetic rehabilitation, communication and conception are achieved using rigorous methodologies such as smile design protocols. The aim of the present pilot study was to compare two innovative strategies that used augmented reality for communication in dentistry. These strategies enable the user to instantly try a virtual smile proposition by taking a set of pictures from different points of view or by using the iPad as an enhanced mirror.

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Dental pulp (DP) is a specialized, highly vascularized, and innervated connective tissue mainly composed of undifferentiated mesenchymal cells, fibroblasts, and highly differentiated dentin-forming odontoblasts. Undifferentiated mesenchymal cells include stem/stromal cell populations usually called dental pulp mesenchymal stem cells (DP-MSCs) which differ in their self-renewal properties, lineage commitment, and differentiation capabilities. Analysis of surface antigens has been largely used to precisely identify these DP-MSC populations.

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Objective: Regenerating a functional dental pulp in the pulpectomized root canal has been recently proposed as a novel therapeutic strategy in dentistry. To reach this goal, designing an appropriate scaffold able to prevent the growth of residual endodontic bacteria, while supporting dental pulp tissue neoformation, is needed. Our aim was to create an innovative cellularized fibrin hydrogel supplemented with chitosan to confer this hydrogel antibacterial property.

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A coronoradicular reconstruction (CRR) has conventionally used a metallic inlay core (MIC) or a single-fiber-reinforced composite (sFRC) but extensive dentin removal can lead to root fracture. We propose herein a multi-fiber-reinforced composite (mFRC) based on a bundle of thin flexible fibers that can be adapted to the root anatomy without removing additional dentin. The aim of this study was to compare the mechanical behavior of the root reconstructed with mFRC, MIC, or sFRC using a finite element analysis (FEA).

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Background: Incisor loss constitutes a strong aesthetic and psychologic traumatism for the patient and it remains a challenging situation for the dental practitioner because of the necessity to rapidly replace the lacking tooth. Various therapeutic procedures have been proposed to replace the incisor concerned, for example by using a removable partial denture. However, the manufacturing of such a denture with classical procedures is often subject to processing errors and inaccuracies.

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To overcome difficulties associated with conventional techniques, impressions with IOS (intraoral scanner) and CAD/CAM (computer-aided design and manufacturing) technologies were developed for dental practice. The last decade has seen an increasing number of optical IOS devices, and these are based on different technologies; the choice of which may impact on clinical use. To allow informed choice before purchasing or renewing an IOS, this article summarizes first the technologies currently used (light projection, distance object determination, and reconstruction).

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Article Synopsis
  • The dental pulp (DP) plays a crucial role in maintaining tooth vitality and health by acting as an immune defense system against harmful bacteria during tooth decay.
  • Traditional endodontic treatments focus on disinfecting and sealing the tooth’s inner space, but these methods often fail due to potential re-infections from bacteria.
  • Recent research emphasizes the potential for regenerating a fully functional pulp tissue as a promising approach to enhance tooth defense and discusses various strategies and challenges in achieving this goal.
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Mesenchymal stromal/stem cells (MSCs) from human dental pulp (DP) can be expanded for cell-based and regenerative dentistry therapeutic purposes. However, their heterogeneity may be a hurdle to the achievement of reproducible and predictable therapeutic outcomes. To get a better knowledge about this heterogeneity, we designed a flow cytometric strategy to analyze the phenotype of DP cells and upon expansion with stem cell markers.

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Dental caries is a chronic infectious disease resulting from the penetration of oral bacteria into the enamel and dentin. Microorganisms subsequently trigger inflammatory responses in the dental pulp. These events can lead to pulp healing if the infection is not too severe following the removal of diseased enamel and dentin tissues and clinical restoration of the tooth.

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Primary failure of eruption is a rare condition marked by non-eruption of the posterior teeth due to mutation of a gene responsible for tooth eruption. Today, this anomaly can be detected early using innovative 3D-imaging techniques. Genetic and histologic testing will confirm the diagnosis and unfavorable prognosis.

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In recent years, mesenchymal cell-based products have been developed to improve surgical therapies aimed at repairing human tissues. In this context, the tooth has recently emerged as a valuable source of stem/progenitor cells for regenerating orofacial tissues, with easy access to pulp tissue and high differentiation potential of dental pulp mesenchymal cells. International guidelines now recommend the use of standardized procedures for cell isolation, storage and expansion in culture to ensure optimal reproducibility, efficacy and safety when cells are used for clinical application.

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Introduction: Human dental pulp cells (HDPCs) are generally isolated and cultured with xenogeneic products and in stress conditions that may alter their biological features. However, guidelines from the American Food and Drug Administration and the European Medicines Agency currently recommend the use of protocols compliant with medicinal manufacturing. Our aim was to design an ex vivo procedure to produce large amounts of HDPCs for dentin/pulp and bone engineering according to these international recommendations.

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Article Synopsis
  • The study investigates the role of odontoblasts, the cells responsible for dentin formation, in the immune response to cariogenic bacteria during tooth decay.
  • Researchers stimulated odontoblast-like cells with a TLR2 agonist and found that this activation significantly increased the expression of the NOS2 gene, which is linked to the production of nitric oxide (NO), a compound with antibacterial properties.
  • The findings suggest that odontoblasts contribute to the antimicrobial response against harmful bacteria in the dental pulp and may play a crucial role in the healing and regeneration processes of pulp tissue after carious damage.
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Introduction: Like other tissues in the body, the human dental pulp is equipped with a network of immune cells that can be mobilized against pathogens when they invade the tooth. Very little data, mostly obtained with classic histologic methods, have reported their quantities and relative percentages. The objective of this study was to characterize and precisely quantify immunocompetent cells in healthy human dental pulp by using fluorescence-activated cell sorting, together with identifying specific cell subsets in the leukocyte (CD45(+)) cells.

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High doses of zoledronic acid (ZOL), one of the most potent inhibitors of bone resorption, are currently evaluated in phase III clinical trials in Europe for the treatment of malignant pediatric primary bone tumors. The impact of such an intensive treatment on the craniofacial skeleton growth is a critical question in the context of patients with actively growing skeleton; in particular, in light of our previous studies evidencing that endochondral bone formation was transiently disturbed by high doses of ZOL. Two protocols adapted from pediatric treatments were developed for newborn mice (a total of 5 or 10 injections of ZOL 50μg/kg every two days).

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Article Synopsis
  • Recent studies highlight that human dental pulp stem cells (DPSCs) could be beneficial for treating neurodegenerative diseases, with these cells cultured using methods designed for neural stem/progenitor cells.
  • The methodology involved isolating DPSCs from third molars, followed by enzymatic digestion and cultivation in nutrient-rich media, separating the adherent and non-adherent cell populations for further study.
  • Results showed that adherent DPSCs expressed several neuronal markers while lacking typical hematopoietic stem cell markers, suggesting the presence of neuronal and oligodendrocyte progenitors, with spheroid-forming non-adherent cells also showing relevant gene expression tied to neurogenesis.
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